{"data":{"id":"us/42-cfr-405.1809","jurisdiction":"us","citation":"42 CFR 405.1809","heading":"Contractor hearing procedures.","body":"(a) Hearings. Each contractor must establish and maintain written procedures for contractor hearings, in accordance with the regulations in this subpart, for resolving issues that may arise between the contractor and a provider concerning the amount of reasonable cost reimbursement, or prospective payment due the provider (except as provided in § 405.1804) under the Medicare program. The procedures must provide for a hearing on the contractor determination contained in the notice of program reimbursement (§ 405.1803), if the provider files a timely request for a hearing.\n(b) Amount in controversy. In order for a contractor to grant a hearing, the following dates and amounts in controversy apply:\n(1) For cost reporting periods ending prior to June 30, 1973, the amount of program reimbursement in controversy must be at least $1000.\n(2) For cost reporting periods ending on or after June 30, 1973, the amount of program reimbursement in controversy must be at least $1000 but less than $10,000.","path":["Title 42—Public Health","CHAPTER IV—CENTERS FOR MEDICARE \u0026 MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES","SUBCHAPTER B—MEDICARE PROGRAM","PART 405—FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED","Subpart R—Provider Reimbursement Determinations and Appeals"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-42.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:26:11Z","sha256":"6fb2c57bf6d498abf3bc340a7f49f78534d60b32058a0c728f1a03e3fb702d90","source_id":"us-cfr","stale":true,"prev":"us/42-cfr-405.1807","next":"us/42-cfr-405.1811"},"notice":"GroundRules: Original legal text. Not legal advice."}